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Flexor Tendon Injuries and Associated Complications

Sharp cutting objects and irregular saw-like edges can cause flexor tendon injuries.  A common mechanism of these injuries is kitchen accidents, where a knife edge slips into our hand or fingers.

Construction and industrial workers face even more serious injuries while using mechanical saws and resulting in more extensive tendon injuries. These can be incredibly serious. A tendon laceration inflicted with a sharp edge, in general, will have a better prognosis than one caused by a more irregular cutting tool.

Injured tendons should be repaired in order to restore the motion of the affected finger.  However, these surgeries are so complicated that, to do them well requires substantial expertise. As a result, many surgeons have begun referring to this field of tendon repair as a “No man’s land”.  


Surgical tendon repair goes hand in hand (excuse the pun) with rehabilitation.

Positive outcomes rely on good surgery, effective rehab, and patient cooperation and compliance.

Soon after the surgery, the patient will initiate finger motion in a protected environment. The rehabilitation professional, in turn, will guide the patient through the difficult and sometimes painful process of recovering motion.  

An entire science has evolved around flexor tendon injuries, healing, and rehabilitation. As it turns out, a repaired tendon heals better if you assist it in gliding and moving under some degree of tension. 

However, too much tension and the repair may tear.  Too little tension (as with no rehab and no motion) will lead to severe scarring and stiffness.

Complications From Flexor Tendon Injuries

A flexor tendon laceration itself is difficult to repair and carries a series of challenges not only at the time of surgery but also during rehabilitation.  

A freshly repaired tendon may take up to three months or longer to heal and rehabilitate. In many instances, especially when a repair isn’t viable, the patient may require at least two surgeries. These form part of the reconstruction process.

The difference between a primary repair and a reconstruction is that, in a repair, the surgeon can fix the problem by reattaching the tendon ends in a single surgery.   

Reconstruction, meanwhile, implies that the surgeon could not repair the tendon. Instead, they typically have to implant a temporary plastic or silicone rod to recreate the tendon sheath. Then, after three months, they will perform a second surgery to remove the temporary implant.

Finally, they will perform a tendon graft to replace the original damaged irreparable tendon.  

To recover from the series of surgeries required in a reconstruction, the patient may be out of work for up to six months or longer.

If at all possible, surgeons usually favor a repair over a reconstruction.

Most surgeons will perform a tendon reconstruction when the delay to surgery from the initial injury is longer than three weeks. This kind of delay often occurs because patients initially ignore the lesion as a serious injury. More commonly, though, patients simply won’t be referred to the proper hand surgery professional in time.

After three weeks, the tendon will have retracted too much. There will be swelling of the tendon and a shrinking of the sheath, the likes of which a repair will not be able to fix.

Flexor Tendon Injuries And Toby Orthopaedics Repair Tools

Flexor tendon injuries can be incredibly dangerous and complicated if left untreated. Given the relative complexity of repairing them, meanwhile, the complications which can arise can be range from minor to severe.

The TOBY Flexor Tendon Repair Tools provide the only means of successfully enlarging a shrunken tendon sheath. They are also the only means of successfully slipping a swollen tendon back into its sheath.

There are no other tools on the market like the TOBY Tools, making them invaluable in flexor tendon repair.

More than 15,000 surgeries have been performed by surgeons repairing tendons with these tools, and all by word of mouth!

Interested in learning more? Visit TOBY Orthopaedics, today, and discover implants that relieve pain and restore function for a range of mobility issues!

Check out the second part of this article: On Flexor Tendon Injuries.